A Comparison of Ultrasound and MRI Measurements of the Cross-Sectional Area of the Median Nerve at the Wrist

Hersh, Beverly; D’Auria, Jennifer; Scott, Michael James; Fowler, John R.

doi:10.1177/1558944718777833

Cited by 14 publications

(10 citation statements)

References 19 publications

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“…This is due to potential false negatives in a ratio ranging from 16 to 34% [ 1 ]; and (3) the visual analogue Scale, which is highly recommended for measuring pain [ 49 ]. The reason why these tests are more frequently observed may be due to the poor diagnostic utility of other evaluation tools as described by Li Pi Shan R et al [ 50 ], despite the fact that the rest of the diagnostic instruments used in the studies have been to a lower or greater extent credited in other research activities [ 51 , 52 , 53 , 54 , 55 , 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Use of Sonophoresis with Corticosteroids in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis

Martín-Vega

Vinolo-Gil

Pérez-Cabezas

et al. 2022

JPM

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Carpal tunnel syndrome is a neuropathic disease. It is one of the most frequent musculoskeletal pathologies affecting the upper limbs. One of most frequently used non-surgical treatments is corticosteorids. There are several alternatives for corticosteroids administration. One of them is phonophoresis, this being an effective and painless method of treatment. A systematic review and meta-analysis have been conducted over the use of phonophoresis with corticosteroids for the treatment of carpal tunnel syndrome compared to other non-surgical treatment methods. Keywords from Medical Subjects Headings (MeSH) were used in the following databases: Wos, Scopus, CINHAL, SciELO and PeDro. A total of 222 potentially relevant articles were retrieved. Eleven articles analysing the efficacy of phonophoresis with corticosteroids in reducing pain symptoms in individuals with carpal tunnel syndrome were included, 10 of which were used to conduct the meta-analysis. A conclusion could not be reached as to the application of phonophoresis with corticosteroids being better than other treatment methods, except for the perception of pain and an improved motor and sensory nerve conduction in cases of mild to moderate carpal tunnel syndrome.

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Section: Discussionmentioning

confidence: 99%

Use of Sonophoresis with Corticosteroids in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis

Martín-Vega

Vinolo-Gil

Pérez-Cabezas

et al. 2022

JPM

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“…Recently, CTMRI has been demonstrated to be more advantageous than electrophysiological testing [5,6,12]. CT-MRI can visualize the median nerve at high resolution and represents an effective imaging method for visualization of tendons, ligaments, carpal bones, muscles, and other wrist morphological structures [4,6,12]. Several types of research have used CTMRI for the evaluation of CTS and have described characteristic CTMRI findings in CTS patients [4,6,12,19,21].…”

Section: Discussionmentioning

confidence: 99%

“…CT-MRI can visualize the median nerve at high resolution and represents an effective imaging method for visualization of tendons, ligaments, carpal bones, muscles, and other wrist morphological structures [4,6,12]. Several types of research have used CTMRI for the evaluation of CTS and have described characteristic CTMRI findings in CTS patients [4,6,12,19,21]. The reported results include lesions with increased signal intensity on T2-weighted images, swelling of the median nerve in the distal and proximal carpal tunnel, bowing of the flexor retinaculum, and flattening of the medial nerve within the carpal tunnel.…”

Section: Discussionmentioning

confidence: 99%

“…The MNCSA is also a useful morphological parameter for the evaluation of CTS. Many previous researches have used image modalities and focused on a quantitative analysis of the MNCSA in the carpal tunnel, and reported that MNCSA measurements could be useful in assessing CTS [4,9,11,12,26,27]. Ikeda et al [4] demonstrated that CTMRI is a valuable examination for imaging the crosssectional area of the median nerve and has potential as a diagnostic modality for CTS.…”

Section: Discussionmentioning

confidence: 99%

“…The morphological changes in the median nerve resulting from prolonged increased mechanical pressure within the carpal tunnel have already been demonstrated [6]. Apparently, the median nerve cross-sectional area (MNCSA) is considered a useful morphological parameter for the evaluation of CTS [4,[8][9][10][11][12]. However, there have only been limited studies involving investigation of the anatomical basis of median nerve flattening.…”

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confidence: 99%

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The prognostic value of median nerve thickness in diagnosing carpal tunnel syndrome using magnetic resonance imaging: a pilot study

et al. 2020

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Diagnostic accuracy of ultrasound and MR imaging in peroneal neuropathy: A prospective, single‐center study

Oosterbos,

Weerdt,

Lembrechts

et al. 2024

Muscle and Nerve

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Introduction/AimsMagnetic resonance imaging (MRI) findings in peroneal neuropathy are not well documented and the prognostic value of imaging remains uncertain. Upper limits of cross‐sectional area (CSA) on ultrasound (US) have been established, but uncertainty regarding generalizability remains. We aimed to describe MRI findings of the peroneal nerve in patients and healthy controls and to compare these results to US findings and clinical characteristics.MethodsWe prospectively included patients with foot drop and electrodiagnostically confirmed peroneal neuropathy, and performed clinical follow‐up, US and MRI of both peroneal nerves. We compared MRI findings to healthy controls. Two radiologists evaluated MRI features in an exploratory analysis after images were anonymized and randomized.ResultsTwenty‐two patients and 38 healthy controls were included. Whereas significant increased MRI CSA values were documented in patients (mean CSA 20 mm2 vs. 13 mm2 in healthy controls), intra‐ and interobserver variability was substantial (variability of, respectively, 7 and 9 mm2 around the mean in 95% of repeated measurements). A pathological T2 hyperintense signal of the nerve was found in 52.6% of patients (50% interobserver agreement). Increased CSA measurements (MRI/US), pathological T2 hyperintensity of the nerve and muscle edema were not predictive for recovery.DiscussionImaging is recommended in all patients with peroneal neuropathy to exclude compressive intrinsic and extrinsic masses but we do not advise routine MRI for diagnosis or prediction of outcome in patients with peroneal neuropathy due to high observer variability. Further studies should aim at reducing MRI observer variability potentially by semi‐automation.

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A Comparison of Ultrasound and MRI Measurements of the Cross-Sectional Area of the Median Nerve at the Wrist

Abstract: Results of this study suggest that US is an accurate method to measure CSA of the median nerve at the carpal tunnel inlet. The mean difference between US and MRI was unlikely to be clinically significant.

Cited by 14 publications

References 19 publications

Use of Sonophoresis with Corticosteroids in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis

Use of Sonophoresis with Corticosteroids in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis

The prognostic value of median nerve thickness in diagnosing carpal tunnel syndrome using magnetic resonance imaging: a pilot study

Diagnostic accuracy of ultrasound and MR imaging in peroneal neuropathy: A prospective, single‐center study

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